NPIMap

Organization Active NPI

Maxim of New York, LLC

  • Home Health Agency
  • Long Island City, NY
National Provider Identifier
1023129558
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1121L008 Issued in NY
Legal business name
MAXIM OF NEW YORK, LLC
Practice address
4402 23Rd St
Suite 103
Long Island City, NY 11101-5000
Phone
(718) 361-5490
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chris Sipes
Title
Controller
Phone
(410) 910-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1121L008 NY Primary

Addresses

Primary practice location

4402 23Rd St
Suite 103
Long Island City, NY 11101-5000

Mailing address

7227 Lee Deforest Dr
Columbia, MD 21046-3236

Other identifiers 2

IdentifierTypeStateIssuer
02621396-009MedicaidNY
0232438508MedicaidNY

Other names 1

  • Maxim Healthcare Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maxim Healthcare Services12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4402 23rd St
Ste 103
Long Island City, NY 11101
Phone (718) 361-5490

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1023129558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 23RD ST",
            "address_2": "SUITE 103",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015000",
            "telephone_number": "718-361-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM OF NEW YORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "SIPES",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "410-910-1500"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "1121L008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02621396-009",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0232438508",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maxim Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.